In Australia, and many other countries, rural and remote areas suffer from a lack of ophthalmic service coverage.
The number of eye injuries, while serious in outcome, makes up only a small percentage of Emergency Department presentations. Therefore resourcing Emergency Departments for this type of specialty is difficult and not cost effective.
Ophthalmology is one of the more expensive specialties in which to set up a practice due to the cost of equipment and devices. Additionally, the equipment used by ophthalmologists for diagnosis is complex and difficult to use. Although trainee doctors are given some exposure to this complex equipment, typically the training is brief and quickly forgotten. Moreover, few ophthalmologists are available to Emergency Departments or to public patients.
Clinically, the eye is something that clinicians from non-ophthalmic backgrounds are reticent to work on. This is because eyes are perceived as sensitive and easily disturbed.
Further complicating the treatment of ophthalmic patients is that, from a patient perspective, the pain of an eye injury may not be directly related to the seriousness of the underlying issue. This adds to both the complexity of any diagnosis and treatment.